Obsessive Compulsive Disorder (OCD)

It is estimated that 2-3 per cent of the UK population has OCD

What is OCD?

OCD or Obsessive Compulsive Disorder is an anxiety disorder in which people experience repetitive and upsetting thoughts and/or behaviours. It is characterised by two main features - obsessions (thoughts that make you anxious) and compulsions (behaviours you engage in to reduce the anxiety).

What are obsessions?

Obsessions are repetitive, intrusive, frequent, unwanted thoughts, images or impulses that cause you to feel anxious or experience emotional discomfort or distress. They can preoccupy the mind and will not disappear, despite your best efforts not to think of them.

Common obsessions can include (but are not limited to):

• fears about dirt, germs and contamination

• doubts about harm coming to yourself or others

• excessive concert with exactness, order or symmetry

• fears of acting out violent or aggressive thoughts or impulses

• unreasonable fears of harming others, particularly loved ones

• abhorrent, blasphemous or sexual thoughts

• religious, sacrilegious, or blasphemous thoughts

• sexual thoughts or images

• urge to hoard possessions

What are compulsions?

Compulsions or rituals are the mental or behavioural acts you do in an attempt to reduce the anxiety caused by the obsessional fears, to set things right, or to neutralise the obsession. 

There are also many types of compulsions which are common for people to carry out in order to reduce the anxiety they feel from the obsessive thoughts or images. 

Common compulsions can include (but are not limited to):

Observable actions such as;

• excessive washing and cleaning

• checking (e.g. window, doors and cooker)

• repeated acts such as repeated touching

• counting

• constantly asking for reassurance from others that everything is okay

• ordering and arranging

• collecting and hoarding

• behaviours that are aimed at reducing the chances of provoking an obsession (e.g. putting all sharp objects out of sight) and acts which reduce obsessional fears (e.g. wearing only certain colours).

Non observable mental compulsions can include;

• repeating words or phrases

• counting

• saying a special word or prayer.

Avoidance - is another big part of OCD. Often someone with OCD will avoid situations in order to prevent them feeling anxious and having to carry out a compulsion. 

OCD and depression - due to the impact OCD can have on a person’s life, how it can interfere with every day activities, work, social and relationships, it is common for OCD sufferers to experience depressive symptoms also. 

What is the best treatment for OCD? 

Cognitive behavioural therapy (CBT) is the best treatment for obsessive compulsive disorder (OCD). CBT is a form of psychotherapy that aims to help individuals understand and change the thoughts and behaviours that contribute to their difficulties.

In CBT for OCD, the therapist works with the individual to identify and challenge their obsessive thoughts (called "cognitions") and to gradually expose them to the things that trigger their compulsive behaviours (called "exposure and response prevention," or ERP).

In exposure and response prevention (ERP) the individual is exposed to the things that trigger their obsessive thoughts and compulsive behaviours, while at the same time being asked to resist engaging in the compulsive behaviour. THis would be done in a planned and graded way, with enough of psycho-education and therapeutic discussion before an indovidial was supported to start ERP.

An example of a person engaging in ERP would be: if an individual with OCD has an obsessive fear of germs, their therapist may ask them to touch a doorknob or shake hands with someone without immediately washing their hands (which would be their usual compulsive behaviour). Over time, and with the guidance of the therapist, the individual learns to manage their anxiety and to reduce their reliance on the compulsive behaviour.

ERP can be a challenging treatment, as it requires the individual to confront their fears and to resist the urge to engage in their compulsive behaviours. However, it has been shown to be very effective in reducing the symptoms of OCD and helping individuals lead more fulfilling lives.

ERP is often carried out in the format of a behavioural experiment to find out useful information that helps to further challenge the underlying beliefs that uphold a person’s OCD.

What is a behavioural experiment and how it is used in the treatment of OCD?

Behavioural experiments are usually conducted as part of cognitive behavioural therapy (CBT) for OCD and are often used in conjunction with other techniques, such as exposure and response prevention (ERP).

A behavioural experiment is a technique used in cognitive behavioural therapy (CBT) to help individuals test and modify their beliefs and assumptions about the world. In the treatment of obsessive compulsive disorder (OCD), behavioural experiments can be used to help individuals challenge and change their obsessive thoughts and beliefs about the importance of their compulsions.

For example, an individual with OCD may believe that their compulsive behaviours (such as constantly checking that the cooker is turned off) are necessary to prevent something bad from happening. A behavioural experiment can be used to help the individual test this belief by gradually exposing themselves to the things that trigger their obsessive thoughts and compulsions (such as leaving the house without checking the cooker) and observing the outcomes. This process can help the individual see that their fears are not necessarily founded and that they can cope with their anxiety without engaging in the compulsive behaviour.

My Therapist Online can help you.

If you suffer from any of the problems detailed above, you may benefit from making an appointment with one of our OCD specialists. Some of our therapists have worked at the national specialist services for the treatment of anxiety disorders including OCD. 

OCD can be effectively controlled and treated. The most evidence based treatment, proven to provide relief from OCD is Cognitive Behavioural Therapy (CBT).  CBT treatment coupled with exposure and response prevention (ERP) is recommended in guidelines published by the The National Institute for Health and Care Excellence (NICE).

Specialist OCD therapists at My Therapist Online

Recommended reading about Obsessive Compulsive Disorder (OCD)

Breaking Free from OCD. Overcoming Obsessive Compulsive Disorder with CBT - By Dr Fiona Challacombe, Dr Victoria Bream Oldfield and Professor Paul Salkovskis.

This book is a must have for anyone wanting to overcome OCD and lead a more fulfilling life. It provides practical and evidence-based strategies for managing OCD symptoms and leading a fulfilling life. The authors, who are leading clinicians and researchers in the field of OCD treatment use clear language and real-life examples to help readers understand the nature of OCD, and offer specific tools and techniques to help manage and overcome obsessive thoughts and compulsive behaviours.

The book is a hugely valuable resource for anyone seeking to better understand and overcome OCD, and its practical approach makes it accessible to individuals at any stage of their journey.

Overcoming Obsessive Compulsive Disorder - by David Veale and Rob Wilson

This book is used as the basis for treatment at the national anxiety disorders units. It is a brilliant resource for anyone seeking to better understand and manage their OCD symptoms, and its practical approach makes it accessible to individuals at any stage of their journey.

The whole book is based on evidence-based strategies for managing OCD symptoms. It offers clear explanations of the nature of OCD and its causes, and provides specific tools and techniques for managing intrusive thoughts and compulsive behaviours. The authors, David and Rob use real-life examples and practical exercises to help readers understand and apply the concepts presented in the book.

The Mindfulness Workbook for OCD: A Guide to Overcoming Obsessions and Compulsions Using Mindfulness and Cognitive Behavioural Therapy - by Jon Hershfield and Tom Corboy

This self help work-book offers practical exercises and techniques to help readers understand their thoughts and feelings, and to develop new ways of thinking and acting that can help overcome OCD.

It is written in a clear and accessible style, making it a useful resource for anyone seeking to overcome OCD, regardless of their background or level of experience with mindfulness or CBT. Overall, the book is highly recommended for anyone looking to better understand and manage their OCD symptoms.

Living Beyond OCD Using Acceptance and Commitment Therapy: A Workbook for Adults - by Patricia E. Zurita Ona | Jan 2021

THis is a comprehensive guidebook which focuses on helping adults overcome Obsessive Compulsive Disorder (OCD) through the use of Acceptance and Commitment Therapy (ACT).

The book offers effective and evidence-based techniques for managing OCD symptoms, including strategies for promoting mindfulness and self-compassion. The authors present the material in a clear and easy-to-understand manner, using real-life examples to illustrate the concepts.

The guidebook also contains practical exercises and activities to help readers internalise and apply the information, as well as track their progress.

"Living Beyond OCD Using Acceptance and Commitment Therapy" is an insightful and helpful guide for anyone looking to better understand and overcome their OCD symptoms, making it accessible to individuals at all stages of their journey.

The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder - by Bruce M. Hyman and Cherlene Pedrick

The authors use a Cognitive Behavioural Therapy (CBT) approach and provide practical and evidence-based strategies for managing OCD symptoms. The book offers clear explanations of the nature of OCD and its causes, and provides specific tools and techniques for managing intrusive thoughts and compulsive behaviors.

The authors, Bruce and Cherlene use real-life examples and practical exercises to help readers understand and apply the concepts presented in the book.

It is a comprehensive and highly effective resource for anyone seeking to better understand and manage their OCD symptoms, making it accessible to individuals at any stage of their journey.

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